Provider Demographics
NPI:1467434035
Name:PAYNE, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:PAYNE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8240 NAAB RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5927
Mailing Address - Country:US
Mailing Address - Phone:317-872-3459
Mailing Address - Fax:317-875-3231
Practice Address - Street 1:8240 NAAB RD
Practice Address - Street 2:SUITE 400
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5927
Practice Address - Country:US
Practice Address - Phone:317-872-3459
Practice Address - Fax:317-875-3231
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2017-12-12
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Provider Licenses
StateLicense IDTaxonomies
IN01027558A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100382030Medicaid
IN677690VMedicare PIN